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Society seminar report

Saturday 12 April 2014


ME/CFS Australia (SA) IncSEMINAR REPORT: MRI Brain Scan Research, Dr Leighton Barnden

Report by committee secretary Peter Mitchell and president James Hackett

We had a very successful beginning to our 2014 series of seminars on Saturday 21 March. Dr Leighton Barnden gave a comprehensive run through the research which the team at The Queen Elizabeth Hospital have been doing on MRI scans of the brain of ME/CFS patients (compared with healthy controls). They have found significant areas of difference in the brains of those with ME/CFS, compared with the healthy controls, and were able to directly correlate ME/CFS symptoms with those differences. These results are extremely significant to ME/CFS sufferers – giving evidence of some of the mechanisms behind some of the most common symptoms. Dr Barnden reminds us that the “summary of our observations and an interpretation, [is] necessarily speculative at this stage, of their meaning.”

Unfortunately we will not have a video of this seminar. However we hope this summary helps to account for the bulk of the seminar's substance. We were delighted that nearly forty people attended to benefit from a fine presentation. This was reassuring because we were not sure how the different time of 3pm might affect members.

The following is from my notes, and I hope that (despite my ME brain problems) I have done the researchers justice with my interpretation (James):

  • Myelin is the insulating covering around nerves that helps maintain its electrical signal strength. If myelin is too thin, the signal strength decreases and nerve function is impaired.
  • White matter (WM) in the brain refers to areas containing more of this myelinated wiring in the brain.
  • Grey matter (GM) in the brain refers to areas containing more of the brain cells at the ends of the WM 'connecting wires’.
  • T1w (T1 weighted) MRI scans contrast WM against GM, which shows the myelin variations.
  • T2w (T2 weighted) MRI scans contrast fluid (eg blood volume) against normal brain tissue (WM and GM).

The midbrain, thalamus, internal capsule, and limbic areas are closely connected, central parts of the brain where the researchers found the variations in ME/CFS subjects’ brain tissue density or activity.

The results showed a strong correlation between brain tissue density changes and disease severity. A significant result was the link between decreased WM volume and disease duration. There was evidence of an approximate 1% decrease in WM per year of CFS duration. They also found a correlation between WM volume decrease and sleeping heart rate.

It was suggested that the reduction in myelination in the midbrain could cause nerve signal impairment (connectivity deficits) in both directions (body to brain, and brain to body). This could mean that the brain thinks there is an autonomic nervous system (eg, heart, gastric, and glandular functions) problem, when there actually isn’t. The brain may be responding to these incorrectly perceived problems with a response that causes inappropriate autonomic system activity = symptoms.

Another interesting finding was that the greater the disability, the more compensatory myelination they found in other parts of the brain. This compensatory myelination is considered to be a form of ‘brain plasticity’ – the brain adapting its structure to optimise its function under changed conditions. They hypothesise that the brain in these patients adds extra myelin to parts of the brain (internal capsule) to compensate for poor conduction coming from the areas affected by the reduced myelin (midbrain).

The connectivity deficits, despite the compensatory myelination, are thought to drive the CFS symptoms as reported by the sufferers in the study. There was also some discussion about blood pressure changes correlated with reduced myelin in the midbrain, hypothalamus and Limbic stressor-response nuclei. And, CFS symptoms correlated with T2w scans (blood volume vs brain tissue) in the limbic nuclei and mesolimbic WM.

Another valuable factor of the research showed that any patient-reported depression as a part of the analysis was shown to be a statistical confound – meaning that depression is not a cause of the illness. So… if anyone is still ignorant enough to suggest ME/CFS is all in your mind, you can correct them by letting them know that it is (at least in part) caused by problems in your brain, but not in your mind.

We hope that the latest report from this team will be published soon, and we are very grateful for all the work Drs Kwiatek, Barnden, and the rest of the QEH team have done.

The following summary is from Dr Barnden:

“Brain MRI images acquired were T1w, T2w and relative grey matter volume and white matter volume. T1w responds to changes in myelin levels, T2w responds to changes in local blood volume.

In 25 CFS subjects and 25 healthy controls:

  • Midbrain white matter volume decreased in CFS with duration of symptoms
  • Internal capsule T1w changes with CFS severity suggested myelin is upregulated there to attempt to compensate for midbrain connectivity deficits
  • T2w correlated with CFS symptoms in limbic nuclei and mesolimbic white matter
  • Resting blood pressures correlated with MR in midbrain, hypothalamus & limbic stressor-response nuclei
  • With impaired conduction, brain-body regressions map the set of brain nuclei that regulate blood pressure and heart vrate under stress
  • Midbrain and mesolimbic connectivity deficits, despite compensatory myelination, drive CFS symptoms"




The society's next seminar is on Saturday 31 May, at the old time of 1 pm this time. The speaker will be Julie Peacock, owner and Principal Physiotherapist of Marion Physiotherapy. Julie is a very experienced physiotherapist with a very clear understanding of gentle exercise appropriate to people with pain and fatigue conditions, including Fibromyalgia and ME/CFS. Julie has spoken for us in the past, with very positive feedback from attendees. The nature of her presentation, which involves the audience as much as they are comfortable, does not lend itself to video, so we would recommend people try to attend.



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